Borom, Shirley
Borom, Shirley is an individual health care provider with primary practice located at 1145 W 5Th Ave , Gary IN 46402-1704. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Other Service Providers / Case Manager/Care Coordinator. Nursing Service Providers / Registered Nurse is her primary health care specialty. Borom, Shirley can be contacted via phone (219) 882-5565.Contact Information
Primary practice address
1145 W 5Th Ave
Gary IN 46402-1704
Phone: (219) 882-5565
Fax: (219) 882-8213
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Nursing Service Providers / Registered Nurse | 163W00000X | 28093654A | Indiana |
Other Service Providers / Case Manager/Care Coordinator | 171M00000X | 28093654A | Indiana |
Profile Details
NPI number | 1649540261 |
---|---|
LBN Legal business name | Borom, Shirley |
Credentials | Registered Nurse (RN) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 12th, 2012 |
Last updated | Jan 12th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1649540261 | NPPES |
Indiana | MEDICAID | 100142050A |
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